1.1 What is fibroadenoma?
Fibroadenoma of the breast is a common benign breast tumor in which patients may discover a lump in the breast and become concerned about the possibility of breast cancer. Fibroadenomas are quite prevalent, and it is estimated that approximately 18-20% of women will experience fibroadenomas at some point in their lives.
Fibroadenomas are characterized by the proliferation of fibrous tissue within the breast, resulting in the formation of a solid lump. It is important to note that fibroadenomas do not undergo malignant transformation or worsen over time. However, if you detect a lump in your breast, it is advisable to consult a doctor to rule out the possibility of breast cancer.
1.2 Symptoms of breast fibroadenoma
Fibroadenomas of the breast most commonly occur in women of childbearing age, especially those under the age of thirty. Many patients with fibroadenomas do not experience any symptoms, and the condition is often discovered through self-examination or during a medical examination. Some women may find fibroadenomas during breast screening through ultrasound or mammography. If a fibroadenoma is larger in size, the patient may notice a painless, firm, and movable lump in the breast. Fibroadenomas can occur as solitary masses or multiple masses, and they can also develop in both breasts simultaneously.
The majority of fibroadenomas are smaller than three centimeters in size, although they can grow slowly over time. Larger fibroadenomas can reach sizes of ten centimeters or more.
1.3 Causes of breast fibroadenoma
Fibroadenomas of the breast are hormone-related, specifically influenced by female hormone secretion. Some fibroadenomas may disappear after menopause.
1.4 Classification of breast fibroadenoma
Simple Fibroadenoma
This type of fibroadenoma is generally smaller than three centimeters. Simple fibroadenomas do not significantly increase the risk of developing breast cancer in the future.
Complex Fibroadenoma
In pathological terms, complex fibroadenomas exhibit cellular proliferation, allowing them to grow rapidly. Women with complex fibroadenomas have a slightly increased risk of developing breast cancer in the future.
Giant Fibroadenoma
Giant fibroadenoma refers to a fibroadenoma with a diameter larger than five centimeters. Due to the compression of adjacent breast tissue, giant fibroadenomas can cause breast deformation. Therefore, surgical removal is recommended for patients with giant fibroadenomas.
Giant Juvenile Fibroadenoma
This type of fibroadenoma is relatively rare and typically affects girls and adolescents between the ages of 10 and 18. These fibroadenomas can grow to a very large size and grow rapidly. Therefore, surgical removal is recommended for patients with giant juvenile fibroadenomas.
1.5 Diagnosis of breast firboadenoma
If you discover a lump, it is important to consult a doctor for an accurate diagnosis and to develop an appropriate treatment plan. Doctors generally recommend a Triple Assessment for diagnosis, which includes:
Clinical Examination
The doctor will first take a detailed medical and family history, as well as examine the patient’s symptoms. During the clinical examination, the doctor will carefully assess and record information about the size, location, and characteristics of the breast lump.
Imaging Studies
Imaging studies include mammography and ultrasound. These imaging studies not only help visualize the location and size of the lump but also provide information on features such as calcifications, lymph nodes in the armpit, and the uniformity of echoes. Additionally, imaging studies can assist the doctor in identifying any other lesions that may be present in both breasts.
Pathological Examination
Pathological examination involves fine-needle aspiration cytology (FNAC) and core needle biopsy. The doctor will extract cells or tissue samples from the lump, which will be examined under a microscope to determine the nature of the lump and provide a definitive pathological diagnosis.
After the Triple Assessment, the doctor can provide an accurate diagnosis and develop an appropriate treatment plan for the patient.
1.6 Management of breast fibroadenoma
For most fibroadenomas, their size remains unchanged, and some may even gradually shrink or disappear without any treatment. Therefore, if the doctor determines, after the Triple Assessment, that the breast lump is benign and the fibroadenoma is small, the patient can opt for conservative management by regularly monitoring the changes in the breast lump.
However, in the following situations, the doctor may recommend surgical removal of the fibroadenoma:
- Fibroadenoma causing pain or discomfort.
- Fibroadenoma progressively increasing in size and causing breast deformation.
- Fibroadenoma reaching a larger size, exceeding two centimeters.
- The results of the Triple Assessment raise suspicion or cannot definitively exclude the possibility of malignancy.
In such cases, surgical removal of the fibroadenoma may be advised.
1.7 Surgical removal of breast fibroadenoma
Depending on the size and location of the fibroadenoma, the surgery can be performed under general anesthesia or local anesthesia. After the administration of anesthesia, the doctor will make an incision above the lump or at an appropriate position on the breast. The fibroadenoma will then be completely excised. Once the bleeding is controlled, the doctor will close the incision with dissolvable sutures. The surgery usually takes about thirty minutes to complete.
1.8 Do I need a regular follow-up for my breast fibroadenoma?
Doctors usually recommend women with fibroadenomas to undergo regular clinical breast examinations and imaging scans to ensure that the fibroadenomas are not undergoing any changes or growth.